Related Conditions

Related Physicians

A hernia occurs when part of an internal organ (usually the
small intestine) protrudes through a weak point or tear in the
peritoneum, the thin muscular wall holding the abdominal
organs in place resulting in a bulge. In an inguinal
hernia, abdominal fat or a loop of small
intestine enters the inguinal canal, a tubular passage through
the lower layers of the abdominal wall. In men, inguinal
hernias typically develop in the groin area near the scrotum,
on one or both (double hernia) sides.

A direct inguinal hernia forms a bulge in the groin
area. An indirect hernia descends into the scrotum. Inguinal
hernias occur predominently in men. If an Inguinal hernias
become incarcerated and then strangulated, it can restrict blood
supply to the small bowel creating a medical emergency.

Description of Procedure

A laparoscopic hernia repair is a type of minimally
invasive surgery, which small incisions are first made in the
abdominal wall and the abdomen inflated with carbon dioxide. A
laparoscope (a thin, tube-like instrument with a small video
camera) and miniature surgical instruments are
then passed through the incisions. Using an external
monitor display, the surgeon pushes the herniated intestine back
into place and repairs the hernia tear. Mesh is then
placed over the area to reinforce the abdominal wall. The
procedure is performed under general anesthesia.

Advantages for Patients

Patients can often go home the same day as the
surgery or within 24 hours

A more rapid return to work and normal activities

Potential Complications

Surgery to repair an inguinal hernia is generally safe and
complications are uncommon. Knowing possible risks allows patients
to report postoperative symptoms to their doctor as soon as they
occur.

Risk of general anesthesia. Before surgery, the
anesthesiologist-a doctor who administers anesthesia-reviews the
risks of anesthesia with the patient and asks about medical history
and allergies to medications. Complications most likely occur in
older people and those with other medical conditions. Common
complications include nausea, vomiting, urinary retention, sore
throat, and headache. More serious problems include heart attack,
stroke, pneumonia, and blood clots in the legs.

Getting out of bed after surgery and moving as soon as the
doctor allows will help reduce the risk of complications such as
pneumonia and blood clots.

Hernia recurrence. A hernia can recur up to
several years after repair. Recurrence is the most common
complication of inguinal hernia repair, causing patients to undergo
a second operation.

Bleeding. Bleeding inside the incision is
another complication of inguinal hernia repair. It can cause severe
swelling and bluish discoloration of the skin around the incision.
Surgery may be necessary to open the incision and stop the
bleeding. Bleeding is unusual and occurs in less than 2 percent of
patients.

Wound infection. The risk of wound infection is
small-less than 2 percent-and is more likely to occur in older
adults and people who undergo more complex hernia repair.2 The person may experience a
fever, discharge from the incision, and redness, swelling, or
tenderness around the incision. Postoperative infection requires
antibiotics and, occasionally, another procedure requiring local
anesthesia to make a small opening in the incision and drain the
infection.

Painful scar. Sometimes people experience
sharp, tingling pain in a specific area near the incision after it
has healed. The pain usually resolves with time. Medicine may be
injected in the area if the pain continues.

Injury to internal organs. Although extremely
rare, injury to the intestine, bladder, kidneys, nerves and blood
vessels leading to the legs, internal female organs, and vas
deferens-the tube that carries sperm-can occur during hernia
surgery and may lead to more operations.

Carlos U. Corvera, M.D.

Associate Professor of Surgery Chief, Hepatobiliary and Pancreas Surgery Division of General Surgery